METHODS: Relevant databases were searched through November 2023. Only studies directly comparing mpMRI and PSMA + MRI (PET/MRI or PET/CT + mpMRI) were included. A meta-analysis with a random-effects model was used to estimate pooled sensitivity, specificity, and area under the curve for each approach.
RESULTS: A total of 19 studies were included. On a patient-level analysis, PSMA + MRI had higher sensitivity (9 studies) than mpMRI for csPCa detection (96% [95% confidence interval (CI): 92%, 98%] vs 89% [95% CI: 81%, 94%]; P = 0.04). The patient-level specificity (4 studies) of PSMA + MRI was 55% (95% CI: 31%-76%) compared with 50% (95% CI: 44%-57%) of mpMRI ( P = 0.67). Region-level sensitivity (10 studies) was 85% (95% CI: 74%-92%) for PSMA + MRI and 71% (95% CI: 58%-82%) for mpMRI ( P = 0.09), whereas specificity (4 studies) was 87% (95% CI: 76%-94%) and 90% (95% CI: 82%-95%), respectively ( P = 0.59). Lesion-level sensitivity and specificity were similar between modalities with pooled data from less than 4 studies.
CONCLUSIONS: PSMA + MRI had superior pooled sensitivity and similar specificity for the detection of csPCa compared with mpMRI in this meta-analysis of head-to-head studies.
方法:到2023年11月检索相关数据库。仅包括直接比较mpMRI和PSMA+MRI(PET/MRI或PET/CT+mpMRI)的研究。使用随机效应模型的荟萃分析来估计合并敏感性,特异性,以及每种方法的曲线下面积。
结果:共纳入19项研究。在患者层面的分析中,PSMA+MRI对csPCa检测的灵敏度(9项研究)高于mpMRI(96%[95%置信区间(CI):92%,98%]vs89%[95%CI:81%,94%];P=0.04)。PSMA+MRI的患者水平特异性(4项研究)为55%(95%CI:31%-76%),而mpMRI为50%(95%CI:44%-57%)(P=0.67)。PSMA+MRI的区域水平敏感性(10项研究)为85%(95%CI:74%-92%),mpMRI为71%(95%CI:58%-82%)(P=0.09),而特异性(4项研究)为87%(95%CI:76%-94%)和90%(95%CI:82%-95%),分别为(P=0.59)。病变水平的敏感性和特异性与来自少于4项研究的合并数据相似。
结论:在这项头对头研究的荟萃分析中,与mpMRI相比,PSMA+MRI对csPCa的检测具有更高的合并敏感性和相似的特异性。